MEDICARE: FEMINA HEALTHCARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	038678	GA

General Provider Information

NPI Number	:	1598920423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FEMINA HEALTHCARE INC.

Provider Business Mailing Address
First Line	:	3229 S CHEROKEE LN
Second Line	:	BUILDING 1400
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-4461
Country	:	US
Telephone Number	:	678-445-8181
Fax Number	:	678-445-8162

Provider Business Practice Location Address
First Line	:	3229 S CHEROKEE LN
Second Line	:	BUILDING 1400
City	:	WOODSTOCK
State	:	GA
Zip	:	30188-4461
Country	:	US
Telephone Number	:	678-445-8181
Fax Number	:	678-445-8162

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	MS. LORRI LACZYNSKI
Credential	:
Telephone Number	:	678-445-8181

Provider Enumeration Date	:	07/21/2008
Last Update Date	:	07/21/2008

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Directions to “FEMINA HEALTHCARE INC. ” Practice Location

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